Early Intervention for Infants and Toddlers
with Hearing Loss and Their Families
"One of the most amazing things a child will learn in his or her lifetime is language: words
and meanings and their use for communicating with others. The early years are a critical
time for learning language, and getting help for a child as early as possible maximizes his
or her window of opportunity to do so." John H. Hager, Assistant Secretary of the Office of
Special Education and Rehabilitative Services in the U.S. Department of Education
Over 100 babies born in Virginia in 2006 were reported to the Virginia Department of Health Early Hearing
Detection and Intervention Program to have hearing loss. (1) The first months in a baby's life are the
most important for a child's overall language development. Early identification and intervention are
critical for development of language, learning and social skills. (2)
All children with hearing loss regardless of severity or current level of development are eligible for
supports and services in Virginia’s early intervention system. (3) The supports and services provided
by the Infant & Toddler Connection of Virginia are offered whether a child has a unilateral or bilateral loss
and whether or not the child has hearing aids, cochlear implants, or other assistive devices.
For children with hearing loss, comprehensive evaluation and assessment will include determination of
developmental levels in the following domains: cognitive, language, social-emotional, adaptive and physical,
including gross and fine motor, and vision and hearing. (4) Cognition, language and communication can be
delayed when a child cannot hear. (2,8) In addition, functional skills in the following areas in comparison to
same age peers will be assessed: social-emotional skills, acquiring knowledge and skills, and taking action
to meet needs. (4)
Service coordination will include the following, as appropriate and as desired by the family:
 Explanation of and assurance that families understand their rights in Virginia’s early intervention
system (5)
 Facilitation of Individualized Family Service Plan meetings (6)
 Emotional support including linking to other families with children who are deaf or hard of hearing,
adults with hearing loss, and/or support groups (7)
 Informational resources including unbiased information about communication options (8)
 Coordination of supports and services, including collaboration with physicians, audiologists, school
personnel, and other community resources. (9)
 Assistance with obtaining sensory devices including hearing aids and/or cochlear implants, and/or
assistive listening technology including help with the process and identification of funding sources.
(10)
 Assistance with transition options including the process for transitioning to Part B Early Childhood
Education and/or community preschool programs (11)
Effective intervention with qualified providers (12) will include:
 Providing unbiased information about communication options (8)
 Providing information about hearing, amplification, and current hearing technology (13)
 Supporting the family and child in learning and using the family’s chosen communication mode(s)
(14)
 Teaching the family strategies to help their child develop cognitive, communication, and language
and pre-literacy skills (14)
 Helping the family and child with the use of sensory devices (14)
 Providing anticipatory guidance in the areas of cognition, language, and communication
development (14)
July 31, 2007
Early Intervention for Infants and Toddlers with Hearing Loss and Their Families
Fact Sheet References
1. Basic Information: [back to top]
Virginia Statistics: http://www.vahealth.org/hearing/data.htm
 Beyond Newborn Hearing Screening: Meeting the Educational and Health Care Needs of Infants
and Young Children with Hearing Loss in America; Report and Recommendations of the 2004
National Consensus conference on Effective Educational and Health Care Interventions for Infants
and Young Children with Hearing Loss: http://www.upstate.edu/pmr/beyond_newborn.pdf (page 7)
 Opening Doors: technology and Communication Options for Children with Hearing Loss:
http://www.ed.gov/about/offices/list/osers/products/opening_doors/index.html
 Center for Disease Control; Early Hearing Detection and Intervention:
http://www.cdc.gov/ncbddd/ehdi/question.htm
 Joint Commission on Infant Hearing Principles and Guidelines for Early Intervention Detection and
Intervention Programs: http://www.audiology.org/NR/rdonlyres/F2077B49-B65C-4198-98306DE9B6D820F8/0/jcihearly.pdf
 American Academy of Pediatrics: National Center of Medical Home Initiatives for Children with
Special Needs: Newborn and Infant Hearing Screening Activities:
http://www.medicalhomeinfo.org/screening/hearing.html
 Joint Committee on Infant Hearing, including Position Statements: http://www.jcih.org
 National Center for Hearing Assessment & Management (NCHAM): http://www.infanthearing.org
o Fact Sheet: http://www.infanthearing.org/resources/fact.pdf
 American Speech-Language-Hearing Association: http://www.asha.org/NR/rdonlyres/3CDA7F660F0C-4BB2-8E57-85D7F7391401/0/HrngLossChldrn.pdf
 Alexander Graham Bell Association for the Deaf and Hard of Hearing:
http://www.agbell.org/DesktopDefault.aspx?p=HL_Information_and_Resources
 Universal Newborn Hearing Screening/American Family Physician (May 2007)
http://www.aafp.org/afp/20070501/1349.html
 National Dissemination Center for Children with Disabilities:
http://www.nichcy.org/pubs/factshe/fs3txt.htm
 National Institute on Deafness and Other Communication Disorders:
http://www.nidcd.nih.gov/health/hearing
2. The Importance of Early Intervention [back to top]

Beyond Newborn Hearing Screening: Meeting the Educational and Health Care Needs of Infants
and Young Children with Hearing Loss in America; Report and Recommendations of the 2004
National Consensus conference on Effective Educational and Health Care Interventions for Infants
and Young Children with Hearing Loss: http://www.upstate.edu/pmr/beyond_newborn.pdf
(especially page 16-30)

Center for Disease Control; Early Hearing Detection and Intervention Fact Sheets:
 http://www.cdc.gov/ncbddd/factsheets/ehdi.pdf
 http://www.cdc.gov/ncbddd/ehdi/nationalgoals.htm

Center for Disease Control; National Early Hearing Detection and Intervention Goals:
http://www.cdc.gov/ncbddd/ehdi/goal3.htm

Hands and Voices:
http://www.handsandvoices.org/articles/early_intervention/early_id_journey.html

Alexander Graham Bell Association for the Deaf and Hard of Hearing: Early Intervention:
http://www.agbell.org/DesktopDefault.aspx?p=Early_Intervention

Center for Disease Control: National Early Hearing Detection and Intervention Home Page:
http://www.cdc.gov/ncbddd/ehdi/default.htm

Gallaudet Research Institute: Literacy and Deaf Students: http://gri.gallaudet.edu/Literacy/#reading

Benefits Resulting from Earlier Identification and Intervention. National Center for Hearing
Assessment & Management (NCHAM): http://www.infanthearing.org/summary/benefits.html
Fact Sheet References
July 31, 2007
Page 2 of 7
3. Eligibility for Part C [back to top]

Virginia Part C Policies and Procedures: State Definition of Development Delay; Definition of
Eligibility for Services: http://www.infantva.org/documents/ovw-PGuideStateDefinition.pdf

April 2007 Letter from John Hager and Margaret Giannini http://www.infantva.org/documents/ovwPGuideStateDefinition.pdf

Hands and Voices: Early Intervention: http://www.handsandvoices.org/idea04regs/index.htm
4. Evaluation and Assessment [back to top]

Virginia Part C Policies and Procedures: Evaluation, Assessment and Nondiscriminatory
Procedures: http://www.infantva.org/documents/ovw-PGuideEvaluationAssessment.pdf

Auditory Developmental Scale: http://www.auditoryverbaltraining.com/scale.htm

Virginia’s System for Determination of Child Progress: http://www.infantva.org/ovwDeterminationChildProgress.htm

Zero to Three: http://www.zerotothree.org/
5. Parent Rights [back to top]

Virginia Part C Policies and Procedures: Procedural Safeguards:
http://www.infantva.org/documents/ovw-PGuideProceduralSafeguards.pdf

Hands and Voices: http://www.handsandvoices.org/articles/fam_perspectives/wo_bias_V8-2.htm
6. Individualized Family Service Plans [back to top]

Virginia Part C Policies and Procedures: Individualized Family Service Plan:
http://www.infantva.org/documents/ovw-PGuideIndividualizedFamilyServicePlans.pdf
7. Family Support/Links to Other Families [back to top]

Guide By Your Side: www.vcu.edu/partnership/GBYS;
http://www.vahealth.org/hearing/documents/Virginia%20Guide%20By%20Your%20Side.pdf

Hands and Voices: http://www.handsandvoices.org/index.htm

Alexandra Graham Bell Association for the Deaf and Hard of Hearing: http://www.agbell.org
8. Informational resources including unbiased information about communication options [back to
top]

CDC: A Parent’s Guide to Hearing Loss: http://www.cdc.gov/ncbddd/ehdi/CDROM/index.html

National Center for Hearing Assessment & Management (NCHAM)
http://www.infanthearing.org/earlyintervention/eilinks.html#communication

National Association of the Deaf http://www.nad.org/site/pp.asp?c=foINKQMBF&b=2639885

Hands and Voices:
o http://www.handsandvoices.org/articles/fam_perspectives/wo_bias_V8-2.htm
o http://www.handsandvoices.org/articles/articles_index.html#ei

Virginia Department of Health: http://www.vahealth.org/hearing/parents.asp

Virginia Resource Directory for Parents of Children with Hearing Loss:
http://www.vahealth.org/hearing/documents/2007%200321%20Virginia%20Resource%20Directory%20final.pdf

Center for Disease Control (CDC) Early Hearing Detection and Intervention:
http://www.cdc.gov/ncbddd/ehdi/

My Baby’s Hearing (Boys Town):
http://www.babyhearing.org/LanguageLearning/EarlyIntervention/index.asp

American Society for Deaf Children: http://www.deafchildren.org

Alexandra Graham Bell Association for the Deaf and Hard of Hearing:
http://www.agbell.org/DesktopDefault.aspx?p=About_Spoken_Language

University of Michigan Health System: Child Hearing Information Links:
http://www.med.umich.edu/childhearinginfo/links.htm
9. Coordination of Supports and Services Across Agencies [back to top]
Fact Sheet References
July 31, 2007
Page 3 of 7

Virginia Part C Policies and Procedures: Individualized Family Service Plans (Service Coordination):
http://www.infantva.org/documents/ovw-PGuideIndividualizedFamilyServicePlans.pdf
10. Obtaining and Funding Hearing Aids and Other Assistive Devices [back to top]

Virginia’s Hearing Aid Loan Bank: http://www.vahealth.org/hearing/valoanerbank.asp

Code of Virginia requirements for assistive technology insurance coverage:
http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+38.2-3418.5

Starkey Hearing Foundation: http://www.sotheworldmayhear.org/

United Healthcare Children’s Foundation: http://www.uhccf.org/

Lions Club: http://www.lions.org

Quota Club: http://www.quota.org/
11. Transition [back to top]

Virginia Part C Policies and Procedures: Transition: http://www.infantva.org/documents/ovwPGuideIndividualizedFamilyServicePlans.pdf
12. Qualified Providers [back to top]

Standards for Early Intervention Service Providers for Infants/Toddlers Who are Deaf/Hard of
Hearing and their Families: http://www.colorado.edu/slhs/mdnc/guidelines.pdf (see appendix 5 for
qualifications)

Early Intervention Providers - National Association of the Deaf
http://www.nad.org/site/pp.asp?c=foINKQMBF&b=2639887

Virginia Part C Policies and Procedures: Personnel Standards:
http://www.infantva.org/documents/ovw-PGuidePersonnelStandards.pdf
13. Hearing Aids, Cochlear Implants, and Other Assistive Devices [back to top]

National Institute on Deafness and Other Communication Disorders:
http://www.nidcd.nih.gov/health/hearing/hearingaid.asp

Hearing Aid Resource for Consumers: http://www.earinfo.com/index.html

Better Hearing Institute: BHI: Assistive Listening Devices: telecoil, ALD, American disability act,
more (http://www.betterhearing.org/hearing_solutions/listeningDevices.cfm)

Cochlear Americas Website: http://www.cochlearamericas.com/
14. Intervention [back to top]
 Joint Commission on Infant Hearing Principles and Guidelines for Early Intervention Detection and
Intervention Programs: http://www.audiology.org/NR/rdonlyres/F2077B49-B65C-4198-98306DE9B6D820F8/0/jcihearly.pdf
 Choices in Deafness Revisited: http://www.infantva.org/documents/wkgNewbornHearingChoicesInDeafnessRevisited.pdf
 Center for Disease Control; National Early Hearing Detection and Intervention: Communicating with
Your Baby: http://www.cdc.gov/ncbddd/ehdi/CDROM/start/communicate.html
 Getting Started with Early Intervention (Boys Town National Research Hospital):
http://www.babyhearing.org/LanguageLearning/EarlyIntervention/interventionteam.asp
 Virginia Policy Page – Intervention for Children with Cochlear Implants:
http://www.infantva.org/documents/pr-PolicyCochlearImplants.pdf
 Alexander Graham Bell Association for the Deaf and Hard of Hearing (Auditory Verbal
Communication): http://www.agbell.org
 National Cued Speech Association: http://www.cuedspeech.org/
 Oral Deaf Education (Site includes free materials): http://www.oraldeafed.org/
 Auditory Oral Communication: http://www.deaflinx.com/DeafEd/OptionsGuide/Oralism.html
 American Sign Language: http://www.americansignlanguage.com/
 American Sign Language Browser: http://www.commtechlab.msu.edu/sites/aslweb/browser.htm
 Learning Sign Language and ASL: http://www.handspeak.com/tour/byte/index.php?byte=getstarted
 Speech Reading:
Fact Sheet References
July 31, 2007
Page 4 of 7


Speech Reading in Context: A Guide for Practice in Everyday Settings:
http://clerccenter.gallaudet.edu/Products/Sharing-Ideas/speech/SI-speech.pdf
http://speechreadinglaboratory.com
Training and Education Opportunities for Providers
 Deaf Education: http://www.deafed.net/PageText.asp?hdnPageId=212
 Links to Early Intervention Resources:
http://www.infanthearing.org/earlyintervention/eilinks.html#communication
 Cochlear Americas online training opportunities: http://www.cochlearamericas.com/Support/291.asp
The following DVDs or Videotapes are available at each Infant & Toddler Connection Local Lead
Agency:
The Home Team: Early Intervention Illustrated
The Art and Science of Home Visits: Early Intervention Illustrated
The following resource is available in several local lead agencies in each region:
PREP Project Manuals (PREP is short for Providing Resources and Education for Professionals in Virginia:
Working With Infants and Young Children Who are Deaf or Hard of Hearing and Their Families)
The Department for the Deaf and Hard of Hearing (http://www.vddhh.org/fyilib.htm) has 7 “Bins”
containing the following resources. These are available for loan to local early intervention systems:
Videotapes/ CD’s
Discovering Cued Speech Instructional Videos
Includes 2 videotapes, Study Guide, and Workbook
This program teaches families and service providers how to use Cued Speech. Four instructors present 10
lessons with demos by parents, children, and professionals. The video and personal workbook should be
used together and may be used also with face-to-face instruction.
Families With Deaf Children
Videotape designed for parents whose child has just been diagnosed with a significant hearing loss; other
parents talk about their experiences.
Families With Hard of Hearing Children
Videotape designed for parents whose child has just been diagnosed with a more moderate hearing loss;
other parents talk about their experiences.
SKI HI Total Communication I
Video Series, twenty 30-minute videos
Ten beginning and ten intermediate tapes with three lessons on each tape. Shows the common ASL sign
and the manual English sign.
Cochlear Implants for Children in Parent-Infant Programs
CD presents in picture and animation information about cochlear implants. Includes what they are,
selection and evaluation process, surgery, post surgery, hookup and follow up, emotional aspects, and
discussion of different perspectives.
Baby See ‘n Sign Volumes I and II
DVDs designed to teach babies 6 months and up. This is a teaching tool for the parents and the baby
which includes a variety of real-life images that relate to a child’s daily life, including animals, food, toys, and
activities.
Volume I: Object-word association
Fact Sheet References
July 31, 2007
Page 5 of 7
Volume II: Object-word association continued, Beginning Abstract Concepts
Books
Choices in Deafness: A Parents’ Guide to Communication Options, Second Edition. Designed for parents
as a guide to communication options including auditory-verbal approach, Bilingual-Bicultural Approach,
Cued Speech, Oral Approach, and Total Communication
References and Handbooks
Sign Language for the Family, A Total Communication Picture Reference Book
Includes sign activity and reference booklet written for parents. Used as a quick reference that includes
illustrations and corresponding pictures. This can also be used to practice tool in creating sentences.
Developing Cognition in Young Children Who are Deaf, Second Edition
Handbook presents ideas for ways to promote early thinking skills, especially cognitive skills that promote
early communication and language development. Approximately 100 pages. This program can be used in
conjunction with SKI-HI curriculum.
Sign with your Baby
A quick reference guide in ASL version that can be used to introduce basic signs to your baby. Some signs
include actions, foods, toys, and common labels around the house and community. It is laminated so that it
can be posted on the wall or fridge for easy reference. There is a space to record written notes on the
progress of the child.
Curriculum
Learn To Talk Around The Clock
The Learn To Talk Around The Clock program is an oral, early intervention program designed for
professionals to use with parents of children who are deaf or hard of hearing, birth to three years old. It is a
great tool for teachers, speech-language pathologists, early childhood professionals, special educators, and
educational audiologists. This colorful set includes everyday life activities to use in planning for families.
SKI HI Curriculum
This manual (two huge yellow binders) is a comprehensive program for home-based, early intervention for
children who are deaf and hard of hearing and their families. It includes theory, lesson plans and graphics
for: hearing aid management, communication programs including all methodologies, supporting the family,
etc.
INSITE Curriculum
This two-volume (tan/brown colored binders) is a manual containing home-based programming for families
of young children who are sensory impaired with additional special needs (multi-disabled sensory impaired).
Volume I: Communication and Hearing
Volume II: Vision, Cognition, Motor Impairment, and Developmental Resources
Consultation Resources
Virginia Network of Consultants For Professionals Who Work with Children Who are Deaf or Hard of
Hearing (VNOC)
The Virginia Department of Education (VDOE), in collaboration with the Virginia Department of Health, and
the Partnership for People with Disabilities at Virginia Commonwealth University established the Virginia
Network Of Consultants (VNOC) for Professionals Working with Children Who are Deaf or Hard of Hearing.
The purpose of VNOC is to provide consultant services and training to professionals who work with students
who are deaf or hard of hearing in school divisions and state operated programs in Virginia. It is designed to
promote and enhance educational services for individual students or provide needed training for personnel.
Fact Sheet References
July 31, 2007
Page 6 of 7
VNOC specialists were selected to represent all regions of the Commonwealth and have expertise in one or
more areas as they relate to children who are deaf or hard of hearing. These include: instructional
strategies, communication methodologies, amplification needs, assistive technology, meeting the needs of
students with cochlear implants, and assessment.
There is funding from VDOE to support this initiative on a reimbursement basis. For more information about
VNOC services, contact the VNOC Coordinator, Partnership for People with Disabilities at VCU, at (804)
828-1342 or www.vcu.edu/partnership.
Ann W. Hughes, VNOC Coordinator
Partnership for People with Disabilities
Virginia Commonwealth University
700 East Franklin Street
P.O. Box 843020
Richmond, Virginia 23284-3020
804-828-1342 (Voice)
804-828-1120 (TTY)
804-828-0042 (Fax)
awhughes@vcu.edu
Virginia Department of Education (VDOE)
The Virginia Department of Education maintains a list of Teachers of the Deaf/Hard of Hearing in school
systems throughout Virginia. Local System Managers can contact Debbie Pfeiffer, the Specialist for Deaf
and Hard of Hearing at the Virginia Department of Education to request that she send information/requests
for contracting or consulting to school based Teachers of the Deaf/Hard of Hearing in their area. Debbie
can be contacted at debbie.pfeiffer@doe.virginia.gov or (804) 371-4059.
[back to top]
Fact Sheet References
July 31, 2007
Page 7 of 7